The announcement by the American Nurses Credentialing Center (ANCC) that the last exam for the Home Care Nursing Generalist and Specialist Certification would be given in May of 2005 was met with a whimper from the profession and silence from the home care "industry." In past editorials, I shared the leadership efforts, through the Home Care Nursing Forum, to bring home care nurses' needs, including certification, to the home care agenda. Rea (2003) clearly states why clinical certification is important:

Certification has been linked to increased confidence, increased clinical knowledge and increased job satisfaction. Increasingly, agencies and accreditation bodies are encouraging and rewarding staff for certification as evidence of continued professional development...Although original licensure represents a basic knowledge level, certification represents current practice standards and expertise. This is especially true in home health nursing with its unique set of practice requirements. (p. 761)

Yet, as Medicare Pay-for-Performance looms, administrators and financial directors say they realize quality care is paramount to successful outcomes and equitable reimbursement. But the voices demanding increased education and certification for home care nurses are silent. This is not so for our colleagues in public and community health nursing, the specialty with which we share many principles and practices.

In November 2004, when the ANCC announced the need to phase out both existing Community Health/Public Health (CH/PH) nursing certification exams after May 14, 2005, with support of the American Public Health Association, focusing attention to this at their annual meeting, our colleagues rose up. The result?

In early February, the ANCC released the following press release:

The American Nurses Credentialing Center (ANCC) has reconsidered its plan to end the Clinical Specialist (CNS) and Community Health Nurse examinations in May of this year. This change was precipitated by the many letters from Faculty and C/PH nurses sent to the Chair of the Commission on Certification, the President of ANCC and the President of the American Nurses Association. The letters protested the elimination of the exams and documented many reasons as enumerated by the president of the Association of Community Health Nursing Educators (ACHNE) who mobilized their membership.

So here we are in home care, without our own organization to advocate, facilitate, or provide certification. With over 60% of nurses in the country holding an associate degree, the issue of certification can't totally be addressed through the ANCC, but it was a mechanism to keep home care nurses on a peer level with other specialties. With the push for Pay-for-Performance through the Medicare system and quality issues paramount, we must have a way to certify home care nurses!! I pledge myself and the journal to this effort. I welcome your comments with suggestions on how to proceed. Look for more on this subject in future issues.

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